Octavio Rivera Romero ¹ Hyun Wook Chae ² Maria F. Faienza ³ Edoardo Vergani ⁴ Chong Kun Cheon ⁵ Raffaella Di Mase ⁶ Francesco Frasca ⁷ Hae Sang Lee ⁸ Claudia Giavoli ⁹ Jihyun Kim ¹⁰ Antonella Klain ¹¹ Jung E. Moon ¹² Maria L. Iezzi ¹³ James Yeh ¹⁴ Antonio Aversa ¹⁵ Young-Jun Rhie ¹⁶ Ekaterina Koledova ^17*

• ¹ Universidad de Sevilla, Sevilla, Spain
• ² College of Medicine, Yonsei University, Seoul, Seoul, Republic of Korea
• ³ Giovanni XXIII Children's Hospital, Bari, Italy
• ⁴ Agostino Gemelli University Polyclinic (IRCCS), Rome, Lazio, Italy
• ⁵ Pusan National University Yangsan Hospital, Yangsan, South Gyeongsang, Republic of Korea
• ⁶ Federico II University Hospital, Naples, Campania, Italy
• ⁷ Division of Endocrinology, Department of Clinical and Experimental Medicine, University of Catania, Catania, Sicily, Italy
• ⁸ School of Medicine, Ajou University, Suweon, Gyeonggi, Republic of Korea
• ⁹ University of Milan, Milan, Lombardy, Italy
• ¹⁰ Dongguk University Ilsan Hospital, Goyang, Gyeonggi, Republic of Korea
• ¹¹ Santobono Children's Hospital, Naples, Campania, Italy
• ¹² Kyungpook National University, Daegu, North Gyeongsang, Republic of Korea
• ¹³ University of L'Aquila, L'Aquila, Abruzzo, Italy
• ¹⁴ Independent researcher, Seoul, Republic of Korea
• ¹⁵ Magna Græcia University, Catanzaro, Calabria, Italy
• ¹⁶ College of Medicine, Korea University, Seoul, Republic of Korea
• ¹⁷ Merck (Germany), Darmstadt, Germany

To analyze the perspectives of healthcare professionals (HCPs) regarding the acceptance of digital health solutions for growth hormone (GH) deficiency care. This study identified factors impacting HCPs' intent to use and recommend digital solutions supporting recombinanthuman growth hormone (r-hGH) therapy in Italy and Korea with a use case of connected drug delivery system (Aluetta ® with Smartdot™) integrated in a platform for GH treatment support (the Growzen™ digital health ecosystem).Methods: Participatory workshops were conducted in Rome, Italy and Seoul, Korea, to collect the perspectives of 22 HCPs on various predefined topics. HCPs were divided into two teams, each moderated by a facilitator. The workshops progressed in five phases: introduction of the project and experts; capturing views on the current context of digitalization; perceived usefulness and ease of use of Aluetta ® with Smartdot™; exploration of the perception of health technology evolution; and combined team recommendations. Data shared by HCPs on technology acceptance were independently analysed using thematic analysis, and relevant findings were shared and validated with experts.Results: HCPs from both Italy and Korea perceived Aluetta ® with Smartdot™ and the Growzen™ based digital health ecosystem as user-friendly, intuitive, and easy-to-use solutions. These solutions can result in increased adherence, a cost-effective healthcare system, and medication self-management. Although technology adoption and readiness may vary across countries, it was agreed that using digital solutions tailored to the needs of users may help in data-driven clinical decisions and strengthen HCPpatient relationships.HCPs' perspectives on the digitalization in paediatric GH therapies suggested that digital solutions enable automatic, real-time injection data transmission to support adherence monitoring and evidence-based therapy, strengthen HCP-patient relationships, and empower patients throughout the GH treatment process.